Τίτλος:
Additive prognostic value of interleukin-6 at peak phase of dobutamine stress echocardiography in patients with coronary artery disease. A 6-year follow-up study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Interleukin-6 (IL-6) and tissue factor (TF) are elevated after myocardial ischemia during dobutamine stress echo (DSE). We examined the incremental prognostic value of IL-6 or TF measured during DSE over echocardiographic and clinical factors in patients with chronic coronary artery disease (CAD). Methods: We studied 106 patients with angiographically documented CAD. IL-6 and TF were measured at rest, peak, and during recovery. A wall motion score index was calculated. Results: Fifty-seven (54%) patients had ischemia at DSE. During follow-up (63.7 ± 20 months), 36 patients (33%) had an adverse event (12 cardiac deaths, 24 acute coronary events). Patients with events had a higher peak IL-6 (P = .02) but similar rest and recovery IL-6 than those without. Patients with peak IL-6 ≥3.14 pg/mL (upper tertile) had a hazard ratio of 2.7 (95% CI 1.44-5.37) (P < .01 for an adverse event). The addition of peak wall motion score index in a multivariable model including risk factors, ejection fraction, revascularization, and multivessel disease increased the model's c statistic from 0.66 to 0.70 (P = .04). The addition of peak IL-6 further increased the model's c statistic to 0.75 (P = .04). Tissue factor was not related with cardiac events. Conclusions: Interleuikin-6 levels measured during the peak phase of DSE incrementally contribute to risk stratification in patients with chronic CAD. © 2008 Mosby, Inc. All rights reserved.
Συγγραφείς:
Ikonomidis, I.
Athanassopoulos, G.
Stamatelopoulos, K.
Lekakis, J.
Revela, I.
Venetsanou, K.
Marinou, M.
Monaco, C.
Cokkinos, D.V.
Nihoyannopoulos, P.
Περιοδικό:
American Heart Journal
Λέξεις-κλειδιά:
dobutamine; interleukin 6, adult; angiocardiography; article; clinical trial; female; follow up; heart ejection fraction; heart muscle revascularization; human; ischemic heart disease; major clinical study; male; multivariate analysis; priority journal; prognosis; rating scale; risk factor; stress echocardiography; vascular disease; wall motion score index, Aged; Coronary Artery Disease; Echocardiography, Stress; Female; Follow-Up Studies; Heart Catheterization; Humans; Interleukin-6; Kaplan-Meiers Estimate; Male; Middle Aged; Multivariate Analysis; Prognosis; Proportional Hazards Models; ROC Curve; Thromboplastin
DOI:
10.1016/j.ahj.2008.03.020
